Abortion clinics need license, check for coercion

By DAVID EGGERT, Associated Press

Sunday, March 31, 2013

LANSING, Mich. (AP) — Michigan abortion clinics will need a state license and must check to make sure women are not being bullied or pressured into getting an abortion under a new law taking effect today.

Other regulations make clearer the proper disposal of fetal remains, after anti-abortion advocates expressed concern some were not disposed of with dignity.

A more contentious call to ban abortions after 20 weeks of pregnancy was dropped from the legislation last year and never went further than the floor of the GOP-controlled House.

Of Michigan’s 32 clinics that offer surgical abortions, four have licenses. The state estimates 16 more abortion providers need to be licensed as freestanding outpatient surgical facilities under the law because they perform at least 120 abortions a year. Licensure brings annual inspections and a $238 yearly fee, though facilities can avoid licensure if they stop publicly advertising abortion services.

Existing abortion providers also can seek waivers from construction or equipment upgrades mandated for outpatient offices.

“The licensing requirements are reasonable enough that we can accommodate them,” said Lori Lamerand, president and CEO of Planned Parenthood Mid and South Michigan.

Of the four Planned Parenthood locations doing abortions, two already were licensed. One does not need a license because it only offers the abortion pill. The organization will apply for a license for its Flint office this week, she said.

One issue is whether the state has enough money to do licensing and annual inspections. While the Legislature allocated more funding to inspect all outpatient facilities, it is only enough to do them once every three years — not yearly — according to the House Fiscal Agency.

Lamerand said the concern that many abortion clinics are not licensed is a “sound bite that made a lot of people crazy,” but unlicensed abortion providers are providing top-notch care.

“The goal of all this was to limit access and make abortions much more difficult for patients to get,” she said.

Supporters of the law — which was approved primarily along party lines, with some Democrats joining Republicans in support — say it will ensure clinics and private practices offering surgical abortions are sanitary, safe, and have appropriate staff and equipment should complications arise.

“It’s going to mean that clinics that have operated well will just be licensed formally and those clinics that are way below standard are going to have to step up,” said Ed Rivet, lobbyist for Right to Life of Michigan. “The catastrophic claims that abortion advocates said were going to bring to an end abortion in the state, it was Chicken Little then and Chicken Little now.”

The law has a glaring loophole.

It requires abortion providers to post a notice in a prominent location stating it is illegal for anyone to coerce a woman into having an abortion. But no such crime exists — lawmakers never gave final approval to separate legislation that would have criminalized pressuring a woman to get an abortion. A woman also must sign a consent form saying she understands coercive abortion is illegal.

Lamerand said the oversight is “ridiculous” but stressed her clinics already give patients every opportunity to feel comfortable that they want an abortion.

Rivet said he received assurances a new bill outlawing abortion coercion would pass early this year, and he expects legislators to address it after returning from their spring break.

“It’ll come together. It got lost in the details. It shouldn’t have in my view, but now they have to come back around and clean it up,” he said.

According to Futures Without Violence, a San Francisco-based anti-domestic violence group, up to one-quarter of women at abortion clinics report physical or sexual violence at the hands of their partner. The law’s backers say mandatory screening for domestic violence could reduce violence associated with unplanned pregnancies by steering women to safety.

The organization also found, however, that some women who want to terminate pregnancies cannot because of an abusive partner.

Another provision requires that a doctor perform a physical exam before prescribing drugs to induce an abortion. The exam cannot be performed from a distance through use of a Web camera. It is a pre-emptive move because no abortion provider is believed to be doing telemedicine. The provision remains in effect until the end of 2018, when legislators could revisit the issue.

Lamerand credited Gov. Rick Snyder — a Republican who has preferred to focus on economic issues rather than hot-button social issues — for helping to make the final bill more “medically appropriate.”

Additional abortion legislation is expected to be considered in the Legislature this year.

Snyder in December vetoed a bill that would have prevented health insurers from providing elective abortion coverage in their private health plans, while saying he supported such restrictions for plans offered in a new government-sponsored insurance market coming Oct. 1 under the federal health care law.

Though legislative Republicans blocked the governor’s call to partner with the U.S. government on the exchange, they could move to prevent health plans on the federal website from covering elective abortions. Businesses and individuals could buy optional supplemental coverage for elective abortions outside the exchange. Right to Life plans to lobby for the restrictions to apply to all plans, including the health exchange.

“It’s definitely on our agenda in the next few months ahead,” Rivet said.

———Online:Public Act 499: http://1.usa.gov/XMxTRw

———Email David Eggert at deggert(at)ap.org and follow him at http://twitter.com/DavidEggert00